Adaptation into Spanish of the Warwick–Edinburgh Mental Well-being Scale (WEMWBS) and preliminary validation in a student sample

Validation of the Warwick-Edinburgh Mental Well-Being Scale for the Mental Health Surveillance (MHS) of German adults

BACKGROUND

Mental health encompasses more than just the absence of mental disorders. Thus, a Mental Health Surveillance (MHS) and reporting system for Germany should monitor mental well-being in addition to psychopathology to capture a more complete picture of population mental health. The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) is an internationally established inventory for the integrated assessment of different aspects of mental well-being (i.e., hedonic and eudaimonic) in population samples that has not yet been validated for Germany.

METHODS

Using data from a cross-sectional online survey of a convenience sample of N = 1.048 adults aged 18-79 years (51% female) living in Germany, the factorial structure, measurement invariance (age, sex) and psychometric properties of the WEMWBS in its long (14 items) and short (7 items) versions were analyzed. Additionally, correlations to relevant factors (e.g., health-related quality of life, psychological distress) were investigated as indicators of criterion validity.

RESULTS

Means of model fit indices did not confirm a unidimensional factor structure for either version. The three-factor-correlative models showed moderate to good fit while the bifactor model with one general mental well-being factor and three grouping factors fitted the data best. The full range of possible responses was used for all items, and the distribution of both scales was approximately normal. Moreover, the results revealed measurement invariance across sex and age groups. Initial evidence of criterion validity was obtained. Internal consistencies were α = 0.95 and α = 0.89, respectively. Average mental well-being was comparable to that of other European countries at 3.74 for the long version and 3.84 for the short version. While there were no differences by sex, comparisons between age groups revealed higher mental well-being among the older age groups.

CONCLUSIONS

Both versions of the WEMWBS showed sound psychometric characteristics in the present German sample. The findings indicate that the instrument is suitable for measuring mental well-being at the population level due to its distributional properties. These results are promising, suggesting that the scale is suitable for use in a national MHS that aims to capture positive mental health in the population as a foundation for prevention and promotion efforts within public mental health.

Short-term effectiveness of music therapy songwriting for mental health outcomes of at-risk parents in the NICU: a study protocol of an international multicenter mixed-methods trial

BACKGROUND

Preterm birth contributes to adverse mental health outcomes of parents dealing with a premature neonate. The main objective of this study is to determine whether music therapy (MT) songwriting during the infants' stay in the neonatal intensive care unit (NICU) is superior to standard care in reducing the risk of postpartum depression in high-risk parents of preterm children throughout the hospital treatment. The secondary objectives include assessment of effectiveness of MT in other aspects of mental health (anxiety level, perceived stress, mental wellbeing, coping, resilience). Furthermore, this trial will evaluate the medical and social factors that may be associated with the effects of MT songwriting.

PARTICIPANTS AND PROCEDURE

The study design is a sequential mixed method study with a dominant status QUAN to qual. The quantitative trial was designed as a parallel, multicenter, pragmatic, randomized controlled trial. The qualitative study is a descriptive phenomenological study that seeks to understand the lived experiences of participants exposed to songwriting. Participants are parents of premature infants hospitalized in NICU (106 families) in 5 hospitals, in Colombia and Poland. Intervention: 3 MT songwriting sessions per week across 3 weeks. Primary outcome: the risk of postnatal depression; secondary outcomes: anxiety level, mental wellbeing, resilience, stress, coping.

RESULTS

The results will be analyzed quantitatively and qualitatively.

CONCLUSIONS

This study will provide a report on the effectiveness of MT songwriting on mental health in at-risk parents of preterm infants.

Exploring the Relationship Between Self-Compassion and Compassion for Others: The Role of Psychological Distress and Wellbeing

We addressed construct validity and explored the relationship between self-compassion and compassion for others using the two main current operationalizations of compassion (Neff's and the Sussex-Oxford Compassion Scales, SOCSs). Relationships with psychological distress and wellbeing, and potential differences in the association between self-compassion and compassion for others by level of psychological distress and wellbeing were also explored. Participants (n = 811) completed the Spanish adaptations of the Self-Compassion Scale (SCS), the Compassion Scale (CS), the SOCSs (for the self/others), the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), and the Depression Anxiety Stress Scales-21 (DASS-21). We fitted bifactor models to estimate the general factor of each construct for the different operationalizations, and calculated correlations between them. Relationships between self-compassion and compassion for others from the same operationalization were intermediate, while those between the same constructs from different operationalizations were large. Both constructs showed positive associations with wellbeing, while only self-compassion was associated with decreased psychological distress. Participants with good mental health showed higher associations between self-compassion and compassion for others than those with poorer mental health. Self-compassion and compassion for others appear to be dimensional constructs that can converge or diverge. When they converge, it is associated with better mental health.

Factors associated with high and low mental well-being in Spanish university students

BACKGROUND

Previous studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain.

METHODS

MWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables.

RESULTS

Data from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, "high" self-perceived support, and "high" self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. "Middle" self-perceived support, sleeping ≥8 h per day, and "high" self-perceived mental health reduced the odds of low MWB.

LIMITATIONS

The cross-sectional design precludes establishing causal relationships. Data were collected in the 2014-15 academic year using self-reported online surveys.

CONCLUSION

The factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.

Design of a Remote Multiparametric Tool to Assess Mental Well-Being and Distress in Young People (mHealth Methods in Mental Health Research Project): Protocol for an Observational Study

BACKGROUND

Mental health conditions have become a substantial cause of disability worldwide, resulting in economic burden and strain on the public health system. Incorporating cognitive and physiological biomarkers using noninvasive sensors combined with self-reported questionnaires can provide a more accurate characterization of the individual's well-being. Biomarkers such as heart rate variability or those extracted from the electrodermal activity signal are commonly considered as indices of autonomic nervous system functioning, providing objective indicators of stress response. A model combining a set of these biomarkers can constitute a comprehensive tool to remotely assess mental well-being and distress.

OBJECTIVE

This study aims to design and validate a remote multiparametric tool, including physiological and cognitive variables, to objectively assess mental well-being and distress.

METHODS

This ongoing observational study pursues to enroll 60 young participants (aged 18-34 years) in 3 groups, including participants with high mental well-being, participants with mild to moderate psychological distress, and participants diagnosed with depression or anxiety disorder. The inclusion and exclusion criteria are being evaluated through a web-based questionnaire, and for those with a mental health condition, the criteria are identified by psychologists. The assessment consists of collecting mental health self-reported measures and physiological data during a baseline state, the Stroop Color and Word Test as a stress-inducing stage, and a final recovery period. Several variables related to heart rate variability, pulse arrival time, breathing, electrodermal activity, and peripheral temperature are collected using medical and wearable devices. A second assessment is carried out after 1 month. The assessment tool will be developed using self-reported questionnaires assessing well-being (short version of Warwick-Edinburgh Mental Well-being Scale), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) as the reference. We will perform correlation and principal component analysis to reduce the number of variables, followed by the calculation of multiple regression models. Test-retest reliability, known-group validity, and predictive validity will be assessed.

RESULTS

Participant recruitment is being carried out on a university campus and in mental health services. Recruitment commenced in October 2022 and is expected to be completed by June 2024. As of July 2023, we have recruited 41 participants. Most participants correspond to the group with mild to moderate psychological distress (n=20, 49%), followed by the high mental well-being group (n=13, 32%) and those diagnosed with a mental health condition (n=8, 20%). Data preprocessing is currently ongoing, and publication of the first results is expected by September 2024.

CONCLUSIONS

This study will establish an initial framework for a comprehensive mental health assessment tool, taking measurements from sophisticated devices, with the goal of progressing toward a remotely accessible and objectively measured approach that maintains an acceptable level of accuracy in clinical practice and epidemiological studies.

TRIAL REGISTRATION

OSF Registries N3GCH; https://doi.org/10.17605/OSF.IO/N3GCH.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/51298.

Cross-cultural validation of two scales to assess mental wellbeing in persons affected by leprosy in Province 1 and 7, Nepal

To assess mental wellbeing among persons affected by leprosy, this study aimed to validate the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) and the Patient Health Questionnaire (PHQ-9, depression tool) in Province 1 and 7, Nepal. Using purposive and convenience sampling, cross-cultural equivalences were assessed through semi-structured interviews with persons affected by leprosy (>18 years). Data were transcribed, translated, analysed and discussed with experts before revising the tools. Psychometric properties of the scales were assessed using an interviewer-administered questionnaire with cases affected by leprosy and controls not affected by leprosy (>18 years). Statistical analysis included internal consistency, construct validity, floor and ceiling effects, and interpretability. The qualitative study included 20 respondents of whom eleven were female. The statements in the original tools were rephrased to questions as participants had difficulties understanding the statements. Six additional changes were made to ensure items were understood well. The quantitative study included 90 cases (46% female) and 50 controls (54% female). The WEMWBS and PHQ-9 had adequate psychometric properties. Cronbach's alphas were 0.85 and 0.76, respectively, indicating good internal consistency, 75% of hypotheses for construct validity were confirmed, no floor and ceiling effects were found, and data to help users interpret results are presented. Our study provides evidence that the adapted versions of the WEMWBS and PHQ-9 have good cultural validity to measure mental wellbeing and depression among persons affected by leprosy in Province 1 and 7, Nepal.

Understanding the relationship between gender and mental health in adolescence: the Gender Adherence Index (GAI)

Half of all mental health disorders appear during adolescence, although it is still far from clear how they relate to gender (not sex) criteria. This study aims both to analyse the relationship between gender and adolescent mental health and to propose an index: the Gender Adherence Index (GAI). We used cross-sectional, secondary data from 3888 adolescents (aged 13-19) from the FRESC Health Survey on Adolescence in Barcelona. We analysed the interaction among sex, age and socio-economic status with several mental health indices. Additionally, we computed a Gender Adherence Index (GAI) to transcend the information-poor binary sex label, and thus assess to what extent mental health can be predicted by the gender expression of adolescents irrespective of their biological sex. We found that older age and lower economic status have a greater impact on the emotional distress of girls, who reported lower self-perceived mental health than boys. Nevertheless, girls obtained higher scores regarding their prosocial behaviour, which is protective against mental health problems. The GAI was retained in all statistical models stressing it as a relevant metric to explain the variability of adolescent emotional distress. Young people who showed adherence to normative femininity in their lifestyles showed higher prosocial behaviour but did not tend to present more emotional distress. Despite its limitations, this is a novel attempt to explore the relationship between gender expression and mental health. Better defined indices of gender adherence could help us to improve our predictive capacity of mental health disorders during adolescence.

A validation study of the Arabic version of the Warwick-Edinburgh Mental Well-being scale among undergraduate students

BACKGROUND

The main aim of this study was to assess the validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and the short version of the Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) and to evaluate the metric properties of both versions by using a sample of undergraduate students from three Gulf Cooperation Council (GCC) countries (Oman, Qatar, and Saudi Arabia).

METHODS

Six hundred ninety undergraduate students (340 M and 350 F; mean age = 21.16 ± 2.44) from Oman, Qatar, and Saudi Arabia (NOM = 238, NQA = 215, NSA = 237), voluntarily participated in this cross-section study. All of them responded to the WEMWBS, Basic Psychological Needs Satisfaction Frustration (BPNSFS), and Beck Depression Inventory (BDI-II). The methodology involved utilizing descriptive statistics to understand the data's characteristics, internal consistency analysis for reliability, correlation analysis for convergent validity, confirmatory factor analysis to validate the scales, and measurement invariance testing to ensure cross-group comparability. Model fit indices were employed to gauge the goodness of fit.

RESULTS

The translated Arabic versions of the WEMWBS and SWEMWBS showed good reliability, with Cronbach's alpha values of 0.867 and 0.772, respectively. The findings of confirmatory factor analysis asserted the one-factor solution to interpret the item variances of the 14-item WEMWBS and 7-item SWEMWBS. The WEMWBS and SWEMWBS also showed significant positive relationships with need satisfaction and negative relationship with need frustration, and depression. Moreover, the SWEMWBS showed partial scalar invariance across genders and countries, while the WEMWBS showed only partial metric invariance across the three countries and partial scalar invariance across genders.

CONCLUSIONS

Our study highlights the appropriateness of both versions of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) in assessing the psychological well-being of Arab undergraduate students. The employment of these tools is strongly encouraged for the assessment of mental well-being within a comparable adult population.

Exploring the structure and psychometric properties of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) in a representative adult population sample

This article reports the psychometric properties of both full and the abbreviated (Short) Warwick-Edinburgh Mental Well-being Scales (WEMWBS; SWEMWBS) in the Finnish general population. A large cross-sectional dataset (N = 5,335) was collected as part of the nationally representative FinHealth Study in 2017. Exploratory and confirmatory factor analyses of the data evaluated one-, two-, three-, and bi-factorial solutions with a split-half approach. McDonald's omega was used to assess internal consistency and convergent validity was evaluated using four established mental health and well-being scales (BDI-6, GHQ-12, MHI-5, EUROHIS-QOL8). Contrary to previous findings, our results supported a three-factor model of the full scale with separate, yet highly correlated, mental, social, and eudemonic well-being factors. For the SWEMWBS, the bi-factor model showed the best fit, with a strong general mental well-being factor and a weaker specific eudemonic well-being factor. In this sampling context, the social aspect of mental well-being may be considered a separable construct from other mental well-being dimensions and the shorter 7-item version might thus be a preferable option when assessing overall mental well-being.

Mental well-being and test anxiety among students preparing for the university admission exam during the pandemic

Objective

The present study attempted to explore any potential association between test anxiety and mental well-being among high school students preparing for the university admission exam in times of the pandemic.

Methods

The sample of this correlational study consisted of 427 senior high school students in Caycuma district of Zonguldak, Turkey. The data were collected online using a demographic information form, the Warwick-Edinburgh Mental Well-Being Scale, and the Westside Test Anxiety Scale between April-May 2021.

Results

Our findings revealed student gender, paternal education, availability of a personal room and computer, and motivation for online classes to be factors associated with test anxiety. Besides, we discovered parental age, maternal education and employment, the device used for online classes, perceived effectiveness of distance education, and motivation for online classes to be linked with mental well-being among students.

Conclusion

In a nutshell, several factors were discovered to contribute to test anxiety, including student gender, paternal education, availability of a personal room and computer, and motivation for online classes. The findings also suggested some noteworthy factors influencing students' mental well-being, such as parental age, maternal education and employment, the device used for online classes, perceived effectiveness of distance education, and motivation for online classes. Finally, we uncovered a significant negative association between the participating students' test anxiety and mental well-being.

Mental Health and Recreational Angling in UK Adult Males: A Cross-Sectional Study

Exposure to aquatic environments (i.e., blue spaces) can lead to improved mental health and well-being. One meaningful way to spend time in blue spaces is through recreational angling, although limited scientific literature exists on this topic. The present study aims to examine the relationship between recreational angling and mental health and well-being in a sample of UK adult male anglers. A cross-sectional online survey asked questions about demographic characteristics, participation in recreational angling, physical activity levels, diagnosis of psychiatric disorders, and mental health and well-being. Relationships between angling status (i.e., how often and how long participants angled for) and mental health variables were determined using regression models adjusted for age. In total, 1752 participants completed the survey. The regression models found that those who took part in angling more regularly had reduced odds of having depression (p < 0.001), schizophrenia (p = 0.001), suicidal thoughts (p < 0.001), and deliberately self-harming (p = 0.012), in addition to having a higher mental well-being and lower symptoms of depression and anxiety compared to those taking part in angling less frequently. In general, the findings suggest that encouraging frequent participation in recreational angling could be a dual method strategy for promoting relaxation and positive mental health, as well as encouraging increased levels of physical activity in those with mental health issues.

The mental wellbeing of female prisoners in Chile

OBJECTIVE

To measure and understand mental wellbeing among women prisoners in Chile, as part of a larger study.

RESULT

Sixty-eight sentenced prisoners in a women's prison participated in a survey, giving a response rate of 56.7%. Using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the mean wellbeing score of participants was 53.77 out of maximum score of 70. Whilst 90% of the 68 women felt useful at least some of the time, 25% rarely felt relaxed, close to others or able to make up their own minds about things. Data generated from two focus groups attended by six women offered explanations for survey findings. Thematic analysis identified stress and loss of autonomy due to the prison regime as factors which negatively affect mental wellbeing. Interestingly, whilst offering prisoners an opportunity to feel useful, work was identified as a source of stress. Interpersonal factors linked to a lack of safe friendships within the prison and little contact with family had an adverse impact on mental wellbeing. The routine measurement of mental wellbeing among prisoners using the WEMWBS is recommended in Chile and other Latin American countries to identify the impact of policies, regimes, healthcare systems and programmes on mental health and wellbeing.

Psychometric Properties of the Chinese Warwick-Edinburgh Mental Well-being Scale in Medical Staff: Cross-sectional Study

Background

Worldwide, mental well-being is a critical issue for public health, especially among medical staff; it affects professionalism, efficiency, quality of care delivery, and overall quality of life. Nevertheless, assessing mental well-being is a complex problem.

Objective

This study aimed to evaluate the psychometric properties of the Chinese-language version of the 14-item Warwick-Edinburgh Mental Well-being Scale (WEMWBS) in medical staff recruited mainly from 6 hospitals in China and provide a reliable measurement of positive mental well-being.

Methods

A cross-sectional online survey was conducted of medical staff from 15 provinces in China from May 15 to July 15, 2020. Confirmatory factor analysis (CFA) was conducted to test the structure of the Chinese WEMWBS. The Spearman correlations of the Chinese WEMWBS with the 5-item World Health Organization Well-Being Index (WHO-5) were used to evaluate convergent validity. The Cronbach α and split-half reliability (λ) represented internal consistency. A graded response model was adopted for an item response theory (IRT) analysis. We report discrimination, difficulty, item characteristic curves (ICCs), and item information curves (IICs). ICCs and IICs were used to estimate reliability and validity based on the IRT analysis.

Results

A total of 572 participants from 15 provinces in China finished the Chinese WEMWBS. The CFA showed that the 1D model was satisfactory and internal consistency reliability was excellent, with α=.965 and λ=0.947, while the item-scale correlation coefficients ranged from r=0.727 to r=0.900. The correlation coefficient between the Chinese WEMWBS and the WHO-5 was significant, at r=0.746. The average variance extraction value was 0.656, and the composite reliability value was 0.964, with good aggregation validity. The discrimination of the Chinese WEMWBS items ranged from 2.026 to 5.098. The ICCs illustrated that the orders of the category thresholds for the 14 items were satisfactory.

Conclusions

The Chinese WEMWBS showed good psychometric properties and can measure well-being in medical staff.

T. MS, Barakat M, Abdelaziz DH, Mansour NO, Thabit AK, Ramatillah DL, Al-Jumaili AA, Syed NK, Adam MF, Hossain MS, Baraka MA, Jose J, Elkalmi R, Chandran S, Singh Dehele I, Elrggal M, Fathelrahman AI. Assessment of mental wellbeing of undergraduate pharmacy students from 14 countries: The role of gender, lifestyle, health-related, and academic-related factors

Background

Pharmacy students will assume future roles as frontline healthcare providers. Therefore, evaluating their current state of mental wellbeing and its associated factors is essential for better planning students' support initiatives. This study aimed to assess mental wellbeing and its associated factors among undergraduate pharmacy students from 14 countries during the pandemic.

Methods

A cross-sectional study was conducted among undergraduate pharmacy students in 14 countries in Asia and the Middle East. The validated Warwick-Edinburgh Mental Wellbeing Scale (the 14-item WEMWBS) was adopted to assess mental wellbeing. Data collection was performed online between February and April 2022. Descriptive and inferential statistics were used as appropriate.

Results

A total of 2,665 responses were received, mainly from females (68.7%) with a higher presence of private universities (59.1%). About 34.9% had low mental wellbeing levels, while 57 and 8.1% had medium, and high levels, respectively. Binary logistic regression showed that males (AOR: 1.34; CI 95%: 1.11-1.61; p < 0.01) and students with no chronic illnesses (AOR: 2.01; CI 95%: 1.45-2.80; p < 0.001) were more likely to have higher mental wellbeing. Also, participants who did not engage in any exercise (AOR: 0.71; CI 95%: 0.52-0.98; p = 0.04) and those in public universities (AOR: 0.82; CI 95%: 0.69-0.97; p = 0.02) were less likely to have higher mental wellbeing. Additionally, students who had interest/passion for pharmacy (AOR: 1.69; CI 95%: 1.07-2.68; p = 0.02), and those who known pharmacists inspired (AOR: 1.81; CI 95%: 1.06-3.12; p = 0.03), were more likely to have higher mental wellbeing compared with those who had no specific reason for their choice to study pharmacy. The participants with excellent (AOR: 1.87; CI 95%: 1.29-2.70; p = 0.001) or very good self-reported academic performance (AOR: 1.57; CI 95%: 1.12-2.22; p = 0.01) were more likely to have higher mental wellbeing compared to those with fair academic performance.

Conclusion

More than a third of the participants had low mental wellbeing. Various demographic, lifestyle, medical and academic factors appeared to affect students' mental wellbeing. Careful consideration of these factors and their integration into the pharmacy schools' plans for student support services and academic advising would be essential to improve students' mental wellbeing.

Connecting to Nature through 360° Videos during COVID-19 Confinement: A Pilot Study of a Brief Psychological Intervention

Psychological interventions have been shown to be beneficial in mitigating stress related to COVID-19 confinement. According to theories of restorative environments, exposure to natural surroundings has positive effects on well-being and stress through its restorative qualities. With 360° video-based Virtual Reality (VR), people can be exposed to nature and so better manage the consequences associated with mobility restrictions during confinement. The main aim of this pilot study was to examine whether a 360° video-based VR intervention composed of five 13-minute sessions (once a day) has positive effects on affect, well-being, and stress. The sample was made up of 10 participants (4 men and 6 women; age : M = 46.5, SD = 11.7) who were confined at home (voluntarily or not) during the COVID-19 pandemic. Participants were instructed to watch a 360° video each day (of a “beach” or “lake” environment) using their smartphone and VR glasses sent to them by mail. Participants responded with several self-reports before and/or after each session (emotions and sense of presence) and before and/or after the intervention (affect, well-being, perceived stress, perceived restorativeness of nature, and the usefulness and acceptability of the intervention). Results showed a tendency to improve positive (e.g., happiness) and negative (e.g., anxiousness) emotions and experience a high sense of presence after each session. Moreover, perceived restorative qualities of the environment and their cognitive and behavioral effects were high. A significant decrease in negative affect was found after the intervention. Usefulness and acceptability were also high. This is the first study to show that an affordable and accessible technology can be used to overcome the negative consequences of confinement and counteract its harmful psychological effects.

Measuring mental well-being in Sri Lanka: validation of the Warwick Edinburgh Mental Well-being Scale (WEMWBS) in a Sinhala speaking community

BACKGROUND

Well-being is an important aspect of people's lives and can be considered as an index of social progress. The Warwick Edinburgh Mental Well-being scale (WEMWBS) was developed to capture subjective mental well-being. It is a widely tested measure of mental well-being at the population level and has 14 items and a short-form with 7 items. This study was carried out to culturally validate and adapt the WEMWBS among a Sinhala speaking population in Sri Lanka.

METHODS

A forward and backward translation of the scale into Sinhala was done followed by a cognitive interview. The translated and culturally adapted scale and other mental health scales were administered to a sample of 294 persons between the ages of 17-73 using a paper-based version (n = 210) and an online survey (n = 84). Internal consistency reliability and test-retest reliability were tested. Construct validity, and convergent and discriminant validity were assessed using the total sample.

RESULTS

The translated questionnaire had good face and content validity. Internal consistency reliability was 0.91 and 0.84 for the 14-item and 7-item scales, respectively. Test-retest reliability over two weeks was satisfactory (Spearman r = 0.72 p < 0.001). Confirmatory factor analysis supported a one factor model. Convergent validity was assessed using WHO-5 well-being index (Spearman r = 0.67, p < 0.001), Patient Health Questionnaire (PHQ-9) (Spearman r = (-0.45), p < 0.001) and Kessler psychological distress scale (K10) (Spearman r = (-0.55), p < 0.001).

CONCLUSIONS

The translated and culturally adapted Sinhala version of the WEMWBS has acceptable psychometric properties to assess mental well-being at the population level among the Sinhala speaking population in Sri Lanka.

A Polygenic Approach to Understanding Resilience to Peer Victimisation

Previous studies suggest an individual’s risk of depression following adversity may be moderated by their genetic liability. No study, however, has examined peer victimisation, an experience repeatedly associated with mental illness. We explore whether the negative mental health outcomes following victimisation can be partly attributed to genetic factors using polygenic scores for depression and wellbeing. Among participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), we show that polygenic scores and peer victimisation are significant independent predictors of depressive symptoms (n=2268) and wellbeing (n=2299) in early adulthood. When testing for interaction effects, our results lead us to conclude that low mental health and wellbeing following peer victimisation is unlikely to be explained by a moderating effect of genetic factors, as indexed by current polygenic scores. Genetic profiling is therefore unlikely to be effective in identifying those more vulnerable to the effects of victimisation at present. The reasons why some go on to experience mental health problems following victimisation, while others remain resilient, requires further exploration, but our results rule out a major influence of current polygenic scores.

Motivation and learning methods of anatomy: Associations with mental well-being

Appropriate anatomy education for speech and language therapists is a crucial part of preparation for clinical practice. While much research has been conducted regarding the anatomical education of medical students, there is a paucity of evidence for speech and language therapy students. This study assessed the methods employed by a cohort of first-year speech and language therapy students to learn anatomy, their perceptions of the clinical importance of anatomy and motivation to learn anatomy (using a modified version of the motivation strategies for learning questionnaire) and how this related to potential barriers to motivation such as mental well-being (using the Warwick-Edinburgh Mental Well-Being Scale [WEMWBS]). Analysis revealed that 92% of students agreed or strongly agreed that a sound knowledge of anatomy is important for clinical practice, 74% agreed or strongly agreed that listening at lectures was how they primarily learned anatomy, and 91% of students agreed or strongly agreed that they worried a great deal about tests. The latter statement was negatively correlated with a number of statements on the WEMWBS. Overall, the data revealed that first-year speech and language therapy students place importance on anatomy and its role in their future clinical practice, that they have different preferences for learning anatomy compared to medical students, and also have significant anxiety surrounding anatomy examinations. Multiple significant correlations between responses to the motivation and mental well-being questionnaires suggest that there is a significant relationship between first-year student motivation to learn anatomy and well-being.

Mental well-being of the general population: direct and indirect effects of socioeconomic, relational and health factors

PURPOSE

The aim of this study was to analyse the association between individual mental well-being and social, economic, lifestyle and health factors.

METHODS

Cross-sectional study on a representative sample of 13,632 participants (> 15y/o) from the Catalan Health Interview Survey 2013-2016 editions. Mental well-being was assessed with the Warwick-Edinburg Mental Well-being Scale (WEMWBS). Linear regressions were fitted to associate well-being and sociodemographic, relational, lifestyle and health variables according to minimally sufficient adjustment sets identified using directed acyclic graphs. Predictors entered the model in blocks of variable types and analysed individually. Direct and total effects were estimated.

RESULTS

Health factors significantly contributed to mental well-being variance. Presence of a mental disorder and self-reported health had the largest effect size (eta2 = 13.4% and 16.3%). The higher individual impact from a variable came from social support (β = - 12.8, SE = 0.48, eta2 = 6.3%). A noticeable effect gradient (eta2 = 4.2%) from low to high mental well-being emerged according to economic difficulties (from β = 1.59, SE = 0.33 for moderate difficulties to β = 6.02 SE = 0.55 for no difficulties). Younger age (β = 5.21, SE = 0.26, eta2 = 3.4%) and being men (β = 1.32, SE = 0.15, eta2 = 0.6%) were associated with better mental well-being. Direct gender effects were negligible.

CONCLUSIONS

This study highlights health and social support as the most associated factors with individual mental well-being over socioeconomic factors. Interventions and policies aimed to these factors for health promotion would improve population mental well-being.

Factor structure and psychometric properties of a Polish adaptation of the Warwick-Edinburgh Mental Wellbeing Scale

Background

The study of mental wellbeing requires reliable, valid, and practical measurement tools. One of the most widely used measures of mental wellbeing is the Warwick–Edinburgh Mental Wellbeing Scale (WEMWBS). We conducted four studies to validate the Polish version of the WEMWBS. Their objectives are the following: (1) to present the psychometric properties of the Polish version of the WEMWBS (study 1: n = 1197); (2) to evaluate the test–retest reliability of the Polish version of the WEMWBS (study 2: n = 24); (3) to determine the validity of the WEMWBS (study 3: n = 610); (4) to examine sensitivity of the WEMWBS scale to detect population with different levels of pro-health behaviours (study 4: n = 430).

Methods

To explore the dimensional structure of the scale we tested a one-factor model. The evaluation employed explanatory and confirmatory factor analyses and tested reliability and stability. To determine the convergent validity of the WEMWBS we analysed correlations among wellbeing and life satisfaction and risk depression. To examine sensitivity of the WEMWBS scale to detect a population with different levels of health-related behaviours we used Student’s t test.

Results

The results presented confirm that the psychometric properties of the Polish adaptation of WEMWBS are very good. Using EFA and CFA it was shown that a one-factor solution is optimal. Reliability, measured using the Cronbach’s alpha coefficient and McDonald's omega proved to be very high. The estimation of the stability of the Polish version of the WEMWBS proved to be high. Our validation studies also provided data demonstrating sensitivity of the WEMWBS to detect a population with different levels of health-related behaviours, indicating that group with high level of pro-health behaviours achieved higher WEMWBS wellbeing results than group with low level of pro-health behaviours.

Conclusions

WEMWBS was confirmed as a short, reliable and valid measure with good psychometric properties. Due to the high indicators for its psychometric properties, the scale may therefore prove to be a particularly useful tool not only in empirical research, but also in mental wellbeing monitoring, and could serve as support in educational and preventive.

Peer victimisation during adolescence and its impact on wellbeing in adulthood: a prospective cohort study

Background

Peer victimisation is a common occurrence and has well-established links with a range of psychiatric problems in adulthood. Significantly less is known however, about how victimisation influences positive aspects of mental health such as wellbeing. The purpose of this study was therefore to assess for the first time, whether peer victimisation in adolescence is associated with adult wellbeing. We aimed to understand whether individuals who avoid a diagnosis of depression after victimisation, maintain good wellbeing in later life, and therefore display resilience.

Methods

Longitudinal data was taken from the Avon Longitudinal Study of Parents and Children, a prospective cohort study based in the UK. Peer victimisation was assessed at 13 years using a modified version of the bullying and friendship interview schedule, and wellbeing at age 23 using the Warwick-Edinburgh Mental Well-Being Scale. The presence or absence of depression was diagnosed using the Clinical Interview Schedule–Revised at 18 years. A series of logistic and linear regression analyses were used to explore relationships between peer victimisation, depression, and wellbeing, adjusting for potentially confounding individual and family factors.

Results

Just over 15% of victims of frequent bullying had a diagnosis of depression at age 18. Victimisation also had a significant impact on wellbeing, with a one-point increase in frequent victimisation associated with a 2.71-point (SE = 0.46, p < 0.001) decrease in wellbeing scores aged 23. This finding remained after adjustment for the mediating and moderating effects of depression, suggesting that the burden of victimisation extends beyond depression to impact wellbeing. Results therefore show that individuals who remain partially resilient by avoiding a diagnosis of depression after victimisation have significantly poorer wellbeing than their non-victimised counterparts.

Conclusion

Overall, our study demonstrates for the first time that victimisation during adolescence is a significant risk factor for not only the onset of depression, but also poor wellbeing in adulthood. Such findings highlight the importance of investigating both dimensions of mental health to understand the true burden of victimisation and subsequent resilience. In addition to the need for interventions that reduce the likelihood of depression following adolescent victimisation, efforts should also be made to promote good wellbeing.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10198-w.

IMAGINE study protocol of a clinical trial: a multi-center, investigator-blinded, randomized, 36-month, parallel-group to compare the effectiveness of motivational interview in rehabilitation of older stroke survivors

BACKGROUND

Rehabilitation pathways are crucial to reduce stroke-related disability. Motivational Interviewing (MI), as a person-centered complex intervention, aimed to empower and motivate, and could be a resource to improve rehabilitation outcomes for older stroke survivors. The IMAGINE project aims to assess the impact of MI, as a complement to standard geriatric rehabilitation, on functional improvement at 30 days after admission, compared to standard geriatric rehabilitation alone, in persons admitted to geriatric rehabilitation after a stroke. Secondary objectives include assessing the impact of MI on physical activity and performance, self-efficacy, safety, cost-utility, participants' experiences and functional status at 3 months.

METHODS

We will conduct a multicenter randomized clinical trial in three geriatric rehabilitation hospitals in Spain. Older adults after mild-moderate stroke without previous severe cognitive impairment or disability will be randomized into the control or intervention group (136 per group, total N = 272). The intervention group will receive 4 sessions of MI by trained nurses, including the design of a personalized rehabilitation plan agreed between stroke survivors and nurses based on stroke survivors´ goals, needs, preferences and capabilities. Main outcome will be the Functional Independence Measure (FIM). In-hospital physical activity will be measured through accelerometers and secondary outcomes using validated scales. The study includes a process evaluation and cost-utility analysis.

DISCUSSION

Final results are expected by end of 2020. This study will provide relevant information on the implementation of MI as a rehabilitation reinforcement tool in older stroke survivors. A potential reduction in post-stroke disability and dependence would increase person's health-related quality of life and well-being and reduce health and social care costs. IMAGINE has the potential to inform practice and policymakers on how to move forward towards shared decision-making and shared responsibilities in the vulnerable population of older stroke survivors.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT03434938 , registered on January 2018.

Patient-reported well-being: psychometric properties of the world health organization well-being index in specialised community mental health settings

The Five-item World Health Organization Well-being Index (WHO-5) is an increasingly used measure of generic well-being, but there is no evidence to support whether outpatients consider the questionnaire valuable. As the WHO-5 has not yet been psychometrically evaluated in specialised community mental health settings, an evaluation of its validity seems warranted. The aim of this cross-sectional study was to examine the psychometric properties of the WHO-5 in this type of setting. Data was collected from an outpatient center (N = 191 adults). Results indicate that the questionnaire was feasible to administer (n = 57 patients), it reported low mean Burden-scores and high Positive-Value scores, and had excellent internal consistency. No evidence of floor or ceiling effects was found. Results supported the unidimensional structure of the questionnaire. Significant differences were found concerning patients' diagnoses, with patients with schizophrenia diagnoses reporting higher scores and patients with depression and personality disorders reporting lower ones. When comparing the WHO-5 total score and patients' attitudes toward medication, negative correlations were observed with psychological reactance, as well as positive aspects of psychiatric medication. The present study demonstrates that the WHO-5 is feasible to administer and has robust psychometric properties in specialised community mental health centres.

Psychometric Properties of the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) in the Iranian Older Adults

PURPOSE

Mental wellbeing is considered as an important and effective factor in older adults' psychological health. Due to lack of a standard instrument for the assessment of mental wellbeing in Iranian older adults, the present study was performed to examine validity and reliability of the Persian version of the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS-P) for use among Iranian older adults.

PATIENTS AND METHODS

The study sample included 304 older adults aged 60 and over, admitted to the Shohada Educational Hospital affiliated to the Tabriz University of Medical Sciences, North West of Iran. The participants were recruited through the convenience sampling method in May to September 2017.

RESULTS

The mean and standard deviation of the mental wellbeing score were 50.30 and 8.82, respectively. Exploratory factor analysis (EFA) results demonstrated a one-factor solution with 13 items which was verified by the confirmatory factor analysis (CFA). The estimated internal consistency measure of Cronbach's alpha (0.93) and two weeks' time test-retest reliability index (0.84) met the prerequisite criteria.

CONCLUSION

According to the results, the WEMWBS-P with 13 items has acceptable validity and reliability to assess the mental wellbeing of Iranian and other Persian-speaking older adults.

Applicability and cross-cultural validation of the Chinese version of the Warwick-Edinburgh mental well-being scale in patients with chronic heart failure

Background

The mental well-being of patients with chronic heart failure is likely to influence their health-related quality of life and decrease the utilization of public health resources. This study assessed the mental well-being of patients with chronic heart failure and evaluated the reliability and validity of the Warwick-Edinburgh Mental Well-Being Scale.

Methods

We conducted a cross-sectional survey from July 2016 to July 2017 among 191 patients with chronic heart failure, and examined psychometric properties of the Warwick-Edinburgh Mental Well-Being Scale, such as internal consistency, reliability, test-retest reliability, and factorial validity of the Chinese version of the Warwick-Edinburgh Mental Well-Being Scale.

Results

One-dimensional construct validity was demonstrated by confirmatory factor analysis. The psychometric properties of the Chinese version of the Warwick-Edinburgh Mental Well-Being Scale were satisfactory in our sample of patients with chronic heart failure. The internal consistency reliability was .948 and the test-retest reliability .925. The item-total correlations ranged from .405 to .872. There was a strong correlation (r = .79) between the Chinese version of the Warwick-Edinburgh Mental Well-Being Scale and the five-item World Health Organization Well-Being Index. The Chinese version of the Warwick-Edinburgh Mental Well-Being Scale appears acceptable for use in patients with chronic heart failure, and we were able to verify its reliability and validity with our sample.

Conclusions

The Chinese version of the Warwick-Edinburgh Mental Well-Being Scale is a reliable quantitative tool for evaluating mental well-being in patients with chronic heart failure in clinical settings, and this has important implications for overall assessments of mental well-being in patients with chronic heart failure.

Electronic supplementary material

The online version of this article (10.1186/s12955-019-1120-2) contains supplementary material, which is available to authorized users.

Psychometric evaluation of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) with Chinese University Students

Background

The aim of this study was to assess the validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and the SWEMWBS, the shortened version of the WEMWBS, and conduct a preliminary evaluation of the metric properties of these scales by using a sample of university students in mainland China.

Methods

Nine-hundred and three students from a Chinese university participated in the cross-sectional study. The internal consistency, convergent validity, factorial validity and construct validity of the scales were examined.

Results

The Chinese versions of the WEMWBS and SWEMWBS showed high internal consistency, with Cronbach’s alpha values of 0.930 and 0.884, respectively. The results of the exploratory factor analysis suggested that the 14-item WEMWBS and 7-item SWEMWBS were suitable for a single scale. The WEMWBS and SWEMWBS also showed significant moderate to strong correlations with the other major subjective hedonic and eudemonic scales. Both scales showed good model fit in the confirmatory factor analysis, after reorganising several types of error covariance between the items. However, some items in WEMWBS recorded low validity in the evaluation of internal consistency, convergent validity and factorial validity.

Conclusions

This study demonstrated that the SWEMWBS had high validity, internal consistency and psychometric properties when applied to the sample of Chinese students. Further studies should apply this promising scale to samples of other Chinese populations.

Positive mental health and wellbeing in adults with cystic fibrosis: A cross sectional study

OBJECTIVE

Screening for depression and anxiety in people with cystic fibrosis (CF) is recommended but this alone can miss the opportunity to assess and promote positive mental health and wellbeing. This cross-sectional study assessed positive mental health and wellbeing, and associations with physical health and health-related quality of life (HRQoL) in adults with CF.

METHODS

Adults (n = 147) with CF from 9 CF centres in the Republic of Ireland completed the Warwick Edinburgh Mental Well-being scale, the Hospital Anxiety and Depression Scale and the Cystic Fibrosis Questionnaire-Revised. Demographic and physical health outcome data were also collected.

RESULTS

High levels of positive mental health and wellbeing were reported in this sample. There were significant associations between positive 'mental health and wellbeing' and pulmonary function, self-reported physical health and recent hospitalizations. Positive mental health was significantly associated with 11 of the 12 CFQ-R domains assessing HRQoL.

CONCLUSION

Assessing and promoting positive mental health and wellbeing may contribute to improving or maintaining physical and mental health, and HRQoL in patients with cystic fibrosis. It provides valuable clinical information to complement depression and anxiety screening and has potential to track the effectiveness of mental health promotion strategies by assessing and monitoring positive mental health and wellbeing over time. Individuals with CF may benefit from interventions that promote positive mental health and wellbeing by enhancing coping and problem-solving skills and fostering hope and optimism. Future research should focus on the development and testing of positive mental health and wellbeing promotion interventions in people with CF.

The validation of the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) with deaf British sign language users in the UK

Background

There is no validated measure of positive mental well-being that is suitable for Deaf people who use a signed language such as British Sign Language (BSL). This impedes inclusion of this population in a range of research designed to evaluate effectiveness of interventions. The study aims were: (i) to translate the original English version of SWEMWBS into BSL and to test the SWEMWBS BSL with the Deaf population in the UK who use BSL; (ii) to examine its psychometric properties; and (iii) to establish the validity and reliability of the SWEMWBS BSL.

Methods

The SWEMWBS was translated into BSL following a six stage translation procedure and in consultation with the originators. The draft version was piloted with Deaf BSL users (n = 96) who also completed the CORE-OM BSL well-being subscale and the EQ-5D VAS BSL. Reliability was explored using Cronbach’s alpha for internal consistency and ICC for test-retest reliability. Validity was explored by using Kendall’s tau correction for convergent validity and an exploratory factor analysis for construct validity.

Results

The internal consistency for the reliability of the SWEMWBS BSL was found to be good and the test-retest one week apart showed an acceptable reliability. There was good convergent validity of the SWEMWBS BSL with the well-being subscale of the CORE-OM BSL and the EQ-5D VAS BSL.

Conclusions

The SWEMWBS BSL can be used with a Deaf population of BSL users. This is the first validated version of a BSL instrument that focuses solely on positively phrased questions for measuring mental well-being.

Measuring mental well-being in Norway: validation of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS)

BACKGROUND

Mental well-being is an important, yet understudied, area of research, partly due to lack of appropriate population-based measures. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) was developed to meet the needs for such a measure. This article assesses the psychometric properties of the Norwegian version of the WEMWBS, and its short-version (SWEMWBS) among a sample of primary health care patients who participated in the evaluation of Prompt Mental Health Care (PMHC), a novel Norwegian mental health care program aimed to increase access to treatment for anxiety and depression.

METHODS

Forward and back-translations were conducted, and 1168 patients filled out an electronic survey including the WEMWBS, and other mental health scales. The original dataset was randomly divided into a training sample (≈70%) and a validation sample (≈30%). Parallel analysis and confirmatory factor analysis were carried out to assess construct validity and precision. The final models were cross-validated in the validation sample by specifying a model with fixed parameters based on the estimates from the trainings set. Criterion validity and measurement invariance of the (S)WEMWBS were examined as well.

RESULTS

Support was found for the single factor hypothesis in both scales, but similar to previous studies, only after a number of residuals were allowed to correlate (WEMWBS: CFI = 0.99; RMSEA = 0.06, SWEMWBS: CFI = .99; RMSEA = 0.06). Further analyses showed that the correlated residuals did not alter the meaning of the underlying construct and did not substantially affect the associations with other variables. Precision was high for both versions of the WEMWBS (>.80), and scalar measurement invariance was obtained for gender and age group. The final measurement models displayed adequate fit statistics in the validation sample as well. Correlations with other mental health scales were largely in line with expectations. No statistically significant differences were found in mean latent (S)WEMWBS scores for age and gender.

CONCLUSION

Both WEMWBS scales appear to be valid and precise instruments to measure mental well-being in primary health care patients. The results encourage the use of mental well-being as an outcome in future epidemiological, clinical, and evaluation studies, and may as such be valuable for both research and public health practice.

Recovery and creative practices in people with severe mental illness: evaluating well-being and social inclusion

PURPOSE

This mixed (quantitative-qualitative) study evaluates the impact of an artistic workshop on a group of people with severe mental illness (SMI). This study focuses on the impact of creative practices on well-being and social inclusion outcomes.

METHOD

After participating in a creative workshop, 31 people diagnosed with a SMI completed pre/post-intervention measures, namely, the Warwick-Edinburgh Mental Well-Being Scale and the Social Inclusion questionnaire. It was applied in two-way repeated measures analysis of variance. The statistic Wilcoxon and Kruskal-Wallis were applied for non-parametric data to measure pre/post-test effects and workshop experience effects, respectively. In addition to quantitative measures, one observer participated in each workshop that ran in parallel in order to deepen and triangulate quantitative outcomes.

RESULTS

The qualitative and quantitative results show that social inclusion improved in a significant way with an important size effect. Psychological wellbeing increased significantly with a low size effect.

CONCLUSIONS

In accordance with these results, creative practices with people diagnosed with SMI are recommended. In order to increase the impact of these interventions, it is recommended to utilize public space away from clinical environments and to include people without SMI in creative activities together with SMI patients. Implications for Rehabilitation: Creative practices can significantly improve social inclusions and well-being in people with severe mental illness. Participating in creative workshops helps to elaborate personal meanings and promote recovery. Creative practices in mental health services can challenge professional roles and institutional practices. Participation of people with and without severe mental illness engaged together in artistic activities can decrease public stigma.

Translation and validation of a Chinese version of the Warwick-Edinburgh Mental Well-being Scale with undergraduate nursing trainees

WHAT IS KNOWN ON THE SUBJECT?: Warwick-Edinburgh Mental Well-being Scale (WEMWBS) which is a measurement of mental health and well-being, was translated into Chinese to assess the reliability and validity in a sample of undergraduate nursing trainees in Wenzhou. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Currently, there is no a reliable assessment tool to systematically evaluate mental well-being in mainland China. Therefore, we undertook the translation and cultural adaptation of the WEMWBS and tested the scale's reliability and validity. The reliability and validity of the Chinese version of the Short Warwick-Edinburgh Mental Well-being Scale have been demonstrated in Hong Kong, but the WEMWBS has not been validated in mainland China in either clinical or non-clinical settings. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It might provide a reliable quantitative tool to evaluate mental well-being in non-clinical settings, which has important implications for mental health nursing. In future,it might be a reliable quantitative tool for evaluating mental well-being in other population such as hospitalized patients to improve their life quality.

ABSTRACT

Introduction There is growing interest worldwide in the evaluation of positive mental health and wellbeing. Aim This study was to translate the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) into Chinese and assess the reliability and validity of this scale in a sample of undergraduate nursing trainees. Methods A forward and backward translation protocol was used to translate the scale into Chinese. The psychometric properties of the C-WEMWBS, such as internal consistency reliability, test-retest reliability and factorial validity, were analysed. Results All 14 items of the initial C-WEMWBS were rated as conceptually equivalent to those of the original version. Confirmatory factor analysis indicated the emergence of a single factor. The psychometric properties of the C-WEMWBS were satisfactory, with an internal consistency reliability of .94 and a test-retest reliability of .83. The item-total correlations ranged from .66 to .83. There was a moderate relationship (r = .52) between the C-WEMWBS and the WHO-5. Implications for practice This was the first Chinese version of the WEMWBS to be developed and psychometrically assessed with a sample of undergraduate nursing trainees. It provides a reliable quantitative tool to evaluate mental well-being in non-clinical settings, which has important implications for mental health nursing.

Positive Mental Well-Being

This study presents a Rasch-derived short form of the Warwick-Edinburgh Mental Well-Being Scale for use as a screening tool in the general population. Data from 2,005 18- to 69-year-olds revealed problematic discrimination at specific thresholds. Estimation of model fit also deviated from Rasch model expectations. Following deletion of 4 items, the 10 remaining items indicated the data fitted the model. No items showed differential item functioning, thereby making comparisons of overall positive mental well-being for the different age, gender, and income groups valid and accurate. Cronbach’s alpha and Rasch Person Separation Index indicated a strong degree of reliability. Overall, the 10-item scale challenges researchers and clinicians to reconsider the assessment of positive mental well-being.

Predictive models for suicidal thoughts and behaviors among Spanish University students: rationale and methods of the UNIVERSAL (University & mental health) project

BACKGROUND

Suicide is a leading cause of death among young people. While suicide prevention is considered a research and intervention priority, longitudinal data is needed to identify risk and protective factors associate with suicidal thoughts and behaviors. Here we describe the UNIVERSAL (University and Mental Health) project which aims are to: (1) test prevalence and 36-month incidence of suicidal thoughts and behaviors; and (2) identify relevant risk and protective factors associated with the incidence of suicidal thoughts and behaviors among university students in Spain.

METHODS

An ongoing multicenter, observational, prospective cohort study of first year university students in 5 Spanish universities. Students will be assessed annually during a 36 month follow-up. The surveys will be administered through an online, secure web-based platform. A clinical reappraisal will be completed among a subsample of respondents. Suicidal thoughts and behaviors will be assess with the Self-Injurious Thoughts and Behaviors Interview (SITBI) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Risk and protective factors will include: mental disorders, measured with the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and Screening Scales (CIDI-SC), and the Epi-Q Screening Survey (EPI-Q-SS), socio-demographic variables, self-perceived health status, health behaviors, well-being, substance use disorders, service use and treatment. The UNIVERSAL project is part of the International College Surveys initiative, which is a core project within the World Mental Health consortium. Lifetime and the 12-month prevalence will be calculated for suicide ideation, plans and attempts. Cumulative incidence of suicidal thoughts and behaviors, and mental disorders will be measured using the actuarial method. Risk and protective factors of suicidal thoughts and behaviors will be analyzed by Cox proportional hazard models.

DISCUSSION

The study will provide valid, innovative and useful data for developing prevention programs for youth suicide and for improving early identification for high-risk students. The longitudinal design of this study will improve causal interpretation of analyzed associations, needed for generating and validating predictive models. It will represent the first results about suicidal thoughts and behaviors in the Spanish university population. The World Mental Health Survey collaboration will permit accurate cross-national comparisons.

Adaptation and cross-cultural validation of the Brazilian version of the Warwick-Edinburgh mental well-being scale

OBJECTIVE

the Warwick-Edinburgh mental well-being scale (WEMWBS) was designed to assess the level of mental well-being of a population or specific groups. The scale consists of 14 items covering functional psychological aspects, as well as well-being. The final score is calculated by adding up the response of each item, ranging from 1 to 5, obtaining a result from 14 to 70 points.

METHODS

the procedure was developed in accordance with the protocol recommended by the World Health Organization covering translation, back translation, semantic equivalence, expert evaluation of the previous steps, pre-test and final version of the instrument. Following, the final version was applied to a sample of 122 individuals and the data were subjected to descriptive statistical analysis, factor analysis, internal consistency and correlation with other validated instruments.

RESULTS

we performed the instrument's adaptation to the Portuguese spoken in Brazil, replacing terms to approximate the language to expressions of everyday life. The final version showed similar results to those from the original version, demonstrated by factor analysis, internal consistency (Cronbach's alpha: 0.89) and positive correlation with instruments validated to the Portuguese language.

CONCLUSION

the Brazilian version of the WEMWBS proved to be easy to use and understand, showed high internal consistency and construct validity similar to the original instrument.

Positive Mental Well-being in Australian Adolescents: Evaluating the Warwick-Edinburgh Mental Well-being Scale

While there is increasing recognition of the need to go beyond measures of mental ill health, there is a relative dearth of validated tools for assessing mental well-being among adolescents. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is a promising tool for use in this context, and this study evaluated its use in an Australian context. The WEMWBS was completed by 829 Western Australian adolescents, aged from 13 to 16 years old, drawn from Grades 8, 9 and 10 in seven separate high schools. Using confirmatory factor analytic techniques, the utility of the full 14-item scale was not supported, but good fit for a previously validated seven-item short version (SWEMWBS) was supported. Strong measurement invariance was demonstrated across age, and weak measurement invariance was demonstrated across gender. The scale has good internal reliability. There were no differences in SWEMWBS scores across Grades 8 to 10. Overall, the SWEMWBS represents a useful tool for educational, developmental, and school psychologists investigating positive mental wellbeing in younger adolescents.

Temperament and character as determinants of well-being

OBJECTIVES

We aimed to evaluate the effects of Temperament and Character Inventory (TCI) personality measures on well-being scores in a sample of 49-51 year old New Zealanders. Previous research has linked high self-directedness (SD) and low harm avoidance (HA) with well-being. We hypothesised that SD and HA would have predictive power for Warwick-Edinburgh Mental Well-being Scale (WEMWBS) well-being. We anticipated that character profiles with high SD and cooperativeness (CO) would be associated with higher well-being scores while high self transcendence (ST) scores would have less of an influence on well-being in a secular population such as New Zealand. Additionally we aimed to describe and assess the performance of a well-being measure, the WEMWBS and we intended to clarify the factors that underlie the questionnaire.

METHODS

A cohort of 404 randomly selected participants in a study of ageing had WEMWBS means calculated and with principal component analysis used to investigate the factors that underlie the WEMWBS. Multiple hierarchical regression was used to predict WEMWBS scores from socio-demographic and TCI personality variables. ANOVA were used to explore the non-linear effects of personality profiles on well-being.

RESULTS

Principal components analysis revealed one significant factor which explained 54.34% of the variance. After initial univariate analysis current depression, marital status and standard of living were entered at the first step of the multivariate regression. They explained 20% of the variance. In step two the seven TCI personality variables were added to the model, explaining a total of 49% (R(2) change=0.29). Low HA, high SD and the absence of current depression were the main predictors of WEMWBS scores. Character profiles featuring high SD produced significantly higher scores on the WEMWBS. Total WEMWBS scores were normally distributed, and the mean was 52.83 (95% CI 51.96-53.70).

CONCLUSIONS

The key determinants of well-being were absence of current depression and personality variables, especially low HA and high SD. The WEMWBS has face validity and the New Zealand results were very similar to the UK results.

Evaluating the responsiveness of the Warwick Edinburgh Mental Well-Being Scale (WEMWBS): group and individual level analysis

Background

Mental well-being now features prominently in UK and international health policy. However, progress has been hampered by lack of valid measures that are responsive to change. The objective of this study was to evaluate the responsiveness of the Warwick Edinburgh Mental Well-being Scale (WEMWBS) at both the individual and group level.

Methods

Secondary analysis of twelve different interventional studies undertaken in different populations using WEMWBS as an outcome measure. Standardised response mean (SRM), probability of change statistic (P̂) and standard error of measurement (SEM) were used to evaluate whether WEMWBS detected statistically important changes at the group and individual level, respectively.

Results

Mean change in WEMWBS score ranged from −0.6 to 10.6. SRM ranged from −0.10 (95% CI: -0.35, 0.15) to 1.35 (95% CI: 1.06, 1.64). In 9/12 studies the lower limit of the 95% CI for P̂ was greater than 0.5, denoting responsiveness. SEM ranged from 2.4 to 3.1 units, and at the threshold 2.77 SEM, WEMWBS detected important improvement in at least 12.8% to 45.7% of participants (lower limit of 95% CI>5.0%).

Conclusions

WEMWBS is responsive to changes occurring in a wide range of mental health interventions undertaken in different populations. It offers a secure base for research and development in this rapidly evolving field. Further research using external criteria of change is warranted.